Healthcare Provider Details

I. General information

NPI: 1134932783
Provider Name (Legal Business Name): ANGELA WHITNEY-HANDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 183RD ST SE APT M306
BOTHELL WA
98012-7551
US

IV. Provider business mailing address

1225 183RD ST SE APT M306
BOTHELL WA
98012-7551
US

V. Phone/Fax

Practice location:
  • Phone: 206-550-0742
  • Fax:
Mailing address:
  • Phone: 206-550-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61610823
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: